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Together with the other members of the Synaptic Health Alliance – Humana, Multiplan, Optum of the UnitedHealth Group, UnitedHealthcare and Quest Diagnostics – they will try to understand how to use the blockchain to improve data quality and reduce administrative costs.
Specifically, they plan to use blockchain, a distributed ledger of cryptographically linked transactions, to make the directory data of the provider more accurate.
The problem is multifaceted, according to Synaptic. At this time, insurers usually maintain their supplier lists – an expensive effort with insurers, suppliers and others who spend about $ 2.1 billion a year to keep the information up-to-date, the group said. If the directories are not maintained, requests may be delayed and insurers can face fines from the CMS. Suppliers can also be damaged, as they may be incorrectly listed as off-grid for certain plans. This affects patients, who have to resort to potentially inaccurate information.
Errors are not rare. More than half of the directory listings of providers listed in the 64 online directories of Medicare Advantage Organizations had errors, according to data from the CMS examined between September 2016 and August 2017.
If healthcare organizations share demographic information from providers via blockchain, they could help solve the problem and also save money, according to Synaptic. The alliance believes that the blockchain is particularly suited to the problem because it is secure and data changes are passed to all copies in near-real time, a feature that could reduce operational costs, according to Lidia Fonseca, responsible for Quest's information Diagnostics.
Blockchain could also lighten the load on suppliers, said Gerry Lewis, chief information officer of Ascension, who said that the supplier was attracted to the alliance due to both the scale of the companies and the multidisciplinary approach that make it possible.
"We believe this alliance has market presence and the speed to actually change the way we exchange data to provide health care," said Lewis. "Suppliers, payers and consumers: it is necessary that all three are engaged to give a look at this."
Aetna has about 22 million members and Ascension is the largest non-profit healthcare system in the United States.
Down the road, Lewis hopes the alliance will look at how to apply the blockchain to securely share clinical information. But for now, he said, "we're at the point one of probably a 300-step journey".
